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Comparison of Benzhexol and Procyclidine for Tremor in Tremor-Predominant Parkinson's Disease

9. september 2026 oppdatert av: safia bano

Comparison of Effectiveness of Benzhexol and Procyclidine in Improving Tremor in Tremor Predominant Parkinson's Disease Patients

The goal of this clinical trial is to compare benzhexol and procyclidine for improving tremor in adults with tremor-predominant Parkinson's disease who are taking levodopa. Researchers will compare the two medicines to determine whether benzhexol provides similar improvement in tremor to procyclidine and to assess their side effects. Participants will be randomly assigned to receive either benzhexol or procyclidine in addition to their usual levodopa treatment. Motor symptoms and side effects will be assessed before treatment and at 2 weeks, 3 months, and 6 months.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

This randomized clinical trial will compare the effectiveness of benzhexol and procyclidine in improving tremor in patients with tremor-predominant Parkinson's disease who are receiving levodopa therapy.

Eligible participants will be adults aged 40 to 70 years with clinically diagnosed Parkinson's disease, predominant tremor at presentation, Hoehn and Yahr stage 1, 2, or 3, and resting tremor while receiving levodopa/carbidopa monotherapy. Participants with cognitive or behavioral abnormalities, lower urinary tract symptoms, benign prostatic hyperplasia, angle-closure glaucoma, or cardiac disease will be excluded.

Participants will be randomly assigned to one of two treatment groups. Group A will receive benzhexol and Group B will receive procyclidine, in addition to their existing levodopa treatment. Benzhexol will be started at 2 mg on the first day, increased to 2 mg twice daily on day 4 and to 2 mg three times daily on day 7, with subsequent dose adjustment according to tremor response and tolerability. Procyclidine will be started at 2.5 mg three times daily on day 1, increased according to the protocol to a maximum of 5 mg three times daily by day 7, with subsequent dose adjustment according to tremor response and tolerability.

Motor symptoms will be assessed using Part III of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III). The primary assessment will focus on the total tremor subset score comprising the following eight items: postural tremor of the right hand, postural tremor of the left hand, rest tremor amplitude of the right upper extremity, rest tremor amplitude of the left upper extremity, rest tremor amplitude of the right lower extremity, rest tremor amplitude of the left lower extremity, rest tremor amplitude of the lip/jaw, and constancy of rest tremor.

Improvement will be assessed as the absolute change in the total tremor subset score from baseline, with the primary comparison made at the 2-week follow-up. The study aims to determine whether benzhexol provides at least similar improvement in tremor compared with procyclidine.

Participants will be assessed at baseline and at 2 weeks, 3 months, and 6 months after treatment initiation. MDS-UPDRS-III assessments will be performed by an independent observer, and adverse effects and tolerability of the study medications will be assessed and documented at follow-up visits.

The planned study enrollment is 88 participants, with 44 participants allocated to each treatment group. The study will be conducted in the Department of Neurology, Mayo Hospital, Lahore.

Studietype

Intervensjonell

Registrering (Antatt)

88

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Rekruttering
        • Mayo Hospital Lahore
        • Underetterforsker:
          • Ahsan Numan, FCPS,FAAN,FRCP,PhD
        • Ta kontakt med:
        • Hovedetterforsker:
          • Saad A Malik, MBBS
        • Underetterforsker:
          • Safia Bano, FCPS, PhD Scholar

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Diagnosed Parkinson's disease according to the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's Disease, with predominant tremor at presentation.
  • Hoehn and Yahr stage 1, 2, or 3.
  • Any gender.
  • Age 40 to 70 years.
  • Receiving levodopa/carbidopa monotherapy for Parkinson's disease, with resting tremor present.

Exclusion Criteria:

  • Cognitive or behavioral abnormalities.
  • Lower urinary tract symptoms.
  • Benign prostatic hyperplasia.
  • Angle-closure glaucoma.
  • Cardiac disease.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Benzhexol
Participants will receive benzhexol in addition to levodopa/carbidopa therapy. Benzhexol will be started at 2 mg on day 1, increased to 2 mg twice daily on day 4 and to 2 mg three times daily on day 7. The dose will subsequently be adjusted according to resolution of tremor or development of side effects. If tremor resolves, benzhexol will be continued at the effective dose; if intolerable side effects develop, the dose will be reduced and subsequently stopped if side effects persist. Participants will be followed for 6 months with assessments at baseline, 2 weeks, 3 months, and 6 months.
Legemiddel: Benzhexol
Benzhexol will be administered orally. Treatment will start at 2 mg on day 1, increase to 2 mg twice daily on day 4, and increase to 2 mg three times daily on day 7. The dose will subsequently be adjusted according to tremor response and tolerability. Treatment will continue for up to 6 months unless stopped because of persistent intolerable side effects.
Aktiv komparator: Procyclidine
Participants will receive procyclidine in addition to levodopa/carbidopa therapy. Procyclidine will be started at 2.5 mg three times daily on day 1, increased to 5 mg in the morning plus 2.5 mg in the afternoon and evening on day 3, then to 5 mg in the morning and afternoon with 2.5 mg in the evening on day 5, and finally up to 5 mg three times daily on day 7. The dose will subsequently be adjusted according to resolution of tremor or development of side effects. If tremor resolves, procyclidine will be continued at the effective dose; if intolerable side effects develop, the dose will be reduced and subsequently stopped if side effects persist. Participants will be followed for 6 months with assessments at baseline, 2 weeks, 3 months, and 6 months.
Legemiddel: Procyclidine
Procyclidine will be administered orally. Treatment will start at 2.5 mg three times daily on day 1, increase to 5 mg in the morning plus 2.5 mg in the afternoon and evening on day 3, then to 5 mg in the morning and afternoon with 2.5 mg in the evening on day 5, and finally up to 5 mg three times daily on day 7. The dose will subsequently be adjusted according to tremor response and tolerability. Treatment will continue for up to 6 months unless stopped because of persistent intolerable side effects.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change from Baseline in Total Tremor Subset Score of the MDS-UPDRS Part III at 2 Weeks
Tidsramme: From Baseline to Week 2
The total tremor subset score is the sum of Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III tremor items: postural tremor of the right hand, postural tremor of the left hand, kinetic tremor of right hand, kinetic tremor of left hand, rest tremor amplitude of the right upper extremity, rest tremor amplitude of the left upper extremity, rest tremor amplitude of the right lower extremity, rest tremor amplitude of the left lower extremity, rest tremor amplitude of the lip/jaw, and constancy of rest tremor. The minimum score is 0 and maximum score is 40 for tremor subset scores with a lower score indicating better function. Change from baseline will be calculated as the baseline total score minus the total score at 2 weeks, with a greater positive change representing greater improvement in tremor.
From Baseline to Week 2

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total Number of Side Effects
Tidsramme: From Baseline to 6 months
The total number of side effects reported or observed in participants in the benzhexol and procyclidine groups during the study will be recorded and compared between the two treatment groups. Side effects will be assessed and documented during follow-up visits.
From Baseline to 6 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

safia bano

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. september 2026

Primær fullføring (Antatt)

1. juli 2027

Studiet fullført (Antatt)

1. juli 2027

Datoer for studieregistrering

Først innsendt

3. september 2026

Først innsendt som oppfylte QC-kriteriene

3. september 2026

Først lagt ut (Faktiske)

9. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

14. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

9. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 751/RC/KEMU

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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